Beginning January 1, 2021, the new Centers for Medicare and Medicaid Services (“CMS”) Evaluation and Management (“E/M”) guidelines will take effect for Office and Other Outpatient codes *99202-99205 and 99212-99215.  Assignment of these codes will now be determined based on medical decision making (“MDM”) or time.  The need for an extended history and / or exam to support code assignment is eliminated.  The documentation of an appropriate history and examination is left to the performing provider’s judgement.  In this article, a comparison of the old vs. new guidelines for establishing medical decision making will be discussed, compared, and contrasted.  The PDF file is the American Medical Association’s table for reference.

BBB of 2021